| NPI | 1194019562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 816773) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA Rn168245) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2012-06-15 |